The Use of MRI and PET Imaging Studies for Prostate Cancer Management: Brief Update, Clinical Recommendations, and Technological Limitations

Abstract

Multi-parametric magnetic resonance imaging (mpMRI) and positron emission tomography (PET) using prostate-specific membrane antigen (PSMA) targeting ligands have been adopted as a new standard of imaging modality in the management of prostate cancer (PCa). Technological advances with hybrid and advanced computer-assisted technologies such as MR/PET, MR/US, multi-parametric US, and robotic biopsy systems, have resulted in improved diagnosis and staging of patients in various stages of PCa with changes in treatment that may be considered “personalized”. Whilst newer clinical trials incorporate these novel imaging modalities into study protocols and as long-term data matures, patients should be made aware of the potential benefits and harm related to these technologies. Published literature needs to report longer-term treatment efficacy, health economic outcomes, and adverse effects. False positives and negatives of these imaging modalities have the potential to cause harm and the limitations of these technologies should be appreciated. The role of a multi-disciplinary team (MDT) and a shared-decision-making model are important to ensure that all aspects of the novel imaging modalities are considered.

Dynamic Contrast-Enhanced MRI of Prostate Lesions of Simultaneous [68Ga]Ga-PSMA-11 PET/MRI: Comparison between Intraprostatic Lesions and Correlation between Perfusion Parameters

“…A whole-body hybrid PET/MRI scanner with simultaneous acquisition of PET imaging and mpMRI has enabled functional and molecular information to be combined [ 14 , 15 , 16 ]. Initial results suggest that [ 68 Ga]Ga-PSMA-11 PET/MRI is a beneficial imaging method for detecting suspicious focal prostate cancer lesions [ 17 , 18 ] and monitoring recurrence [ 19 ]. Combining MRI and positron emission tomography (PET) improves diagnostic accuracy [ 20 , 21 ].…”

The castration level of testosterone and hormonal resistance of prostate cancer in androgen deprivation therapy

“…Стандартный подход к стадированию, по-видимому, не так точен в диагностике и стадировании пациентов с локализованным заболеванием среднего и высокого риска или микрометастазами; долгосрочные исследования показали, что традиционные технологии визуализации не обнаруживают метастазы у более чем 25% пациентов с метастатическим заболеванием и БХР [42]. Таким образом, с помощью современных методов визуализации можно обнаруживать метастазы на ранней стадии и выявлять пациентов с наиболее высоким риском прогрессирования болезни [43].…”

A targeted near-infrared nanoprobe for deep-tissue penetration and imaging of prostate cancer

“…2 Several new imaging modalities have been trialled, including ultrasound-based imaging, multiparametric (mp)-MRI, mp MRI-US fusion imaging and PET scanning, being selected based on biological behaviour of underlying tumour. 3 However, sub-optimal accuracy in extra-prostatic tumour detection, resulting in biochemical relapse, has highlighted a need for the development of novel imaging probes with higher sensitivity of target tissue. 4 Apart from early detection of cancerous lesions and clinical staging of PCa, 5 radical prostatectomy (RP) has also significantly improved mortality rates when compared with nonsurgical therapeutic strategies like radiation and androgen-deprivation therapy.…”